An Epidemic of Pain
You hit your little toe on the coffee table and your world stops. Agonizing, shooting pain that makes you double over and curse like a sailor. This is a transient pain. You walk it off and you go on. But, what happens when the pain stays? When it’s stuck to you like a shadow?
100 Million Americans suffer from chronic pain according to the American Academy of Pain Management. Compare that to 11.9 million suffering from cancer. According to those numbers, if I know 2 people with cancer I probably know 16 with chronic pain. [1] Those cancer patients could be part of that number, because chronic pain is not an isolated condition. It can be its own disease or be a comorbidity with cancer, diabetes or heart disease.
Demystifying the Paleo Diet!
Good news!
The community classes are back on! If you are interested in Paleo, but are confused by all of the different "versions" of paleo, this class is a good way of defining your own paleo!
The coolest thing is that my school the Southwest College of Naturopathic Medicine is allowing me to teach it FREE OF CHARGE!
If you are in the Phoenix Area, and would like a nice primer into the Paleo Diet, or if you just want to come and learn a little and meet more people from our tribe, join us!
If you are interested, you can sign up HERE!
If you want more info on the philosophy of the program, you can listen to my interview on The Paleo Solution Podcast with Robb Wolf!
The Science Behind Profits
Science is the only compass we have to guide the efficacy of new discoveries and treatments. But we should continue to be skeptics even when something is “double-blind placebo controlled”.
Herpes labialis or “cold sores” are common lesions of the oral mucosa that are prevalent in our population (as many as 1.6 cases per 1000 people).
First let’s learn some virology! Herpes simplex virus 1 or "HSV1", is the virus responsible for those annoying lesions. It is a type of DNA virus, that after infecting the host, causes the painful sore (in the case of HSV1 in the oral mucosa) to help shed itself. Then it runs away to the neural ganglia to “hide” from the immune system. And then it waits. During periods of stress, such as illness or life events, our immune system is compromised and the virus migrates from its hiding spot back to the oral mucosa and BAM! you get another cold sore. Lather, rinse, repeat. Those painful lesions reoccur in one of every three sufferers. [1]
The most frustrating thing about this little virus is that we don’t have a good way of treating it. For example, doconasol commonly known as “Abreva” only reduces the effects of the virus by a whooping 18 hours! [2]
“The median time to healing in the 370 docosanol-treated patients was 4.1 days, 18 hours shorter than observed in the 367 placebo-treated patients (P =.008; 95% confidence interval [CI]: 2, 22).”
The reason the docosanol is not more effective, is because it prevents attachment of the virus to the host cell. Once the virus is inside the cell, then the virus is safe. By the time you begin to feel symptoms, the virus is likely already reproducing inside the cell. You are only preventing more viruses from infecting more adjacent cells. Secondly, by using such a poor mechanism of inhibition, you are selecting for viral particles that are resistant to docosanol. And when they come out of hiding the treatment will be even less effective. Talk about evolutionary mechanisms of survival!
Now, no one is disputing that those are significant results. They were achieved because the number of people treated did benefit from the treatment over placebo. And just like everything science can be motivated by money. Imagine, hundreds of hours spent in labs, millions of dollars spent in trials and product development. There has to be some profit somewhere.
We can see this biased interpretation of scientific results in many places, from food science to nutraceutical science and it turns out that evidence-based medicine is not absolved. The problem is that companies can wordsmith scientific data to make results look better than they actually are. They advertised docosanol as being “able to cut healing time in half”.
The papers and the studies are out there for you to interpret, and if you think that applying a cream every two hours and shortening the infection time by 6.4% is worth the price; then go for it!
The advertisers for doconasol, said it was. And it worked, To the tune of $3,420 per pound of docosanol!
1. Opstelten W, Neven AK, Eekhof J. Treatment and prevention of herpes labialis. Can Fam Physician. 2008;54(12):1683-7.
2. Sacks SL, Thisted RA, Jones TM, et al. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. J Am Acad Dermatol. 2001;45(2):222-30.
Demystifying the Paleo Diet: Customizing Paleo for Your Health
Wednesday, February 24, 5:30pm - 7:30pm
You have decided to adopt a Paleo diet! That was the easy part, but how do you customize it to ensure the biggest impact for your health? Which snacks are the best to keep you satiated? What about Paleo and kids? A well-designed Paleo diet can benefit everyone! In this class, we will discuss the different approaches to Paleo, from fueling a high-intensity athlete to adapting the diet for people with chronic conditions. We will learn how to design your plate and even discuss strategies for successful meal planning.
Class details
- 5:30 PM - 7:30 PM, Wed Feb 24
- Location: Southwest College of Naturopathic Medicine, Community Commons Bldg.
Demystifying The Paleo Diet: What does Science say about Paleo?
Didn’t caveman live to thirty? Doesn’t meat cause cancer? Where will I get all my fiber? What does a typical day of Paleo food look like? In this class, we will discuss why it is scientifically sound to implement a Paleo diet. We will update you with the latest research on supporting a nutritionally dense diet. We will clear the confusion on the macronutrient breakdown of a Paleo diet. Finally, we will discuss how to apply the topics covered to your own lifestyle.
Sign up today!
Demistyfing the Paleo Diet!
Weight loss is a $55 billion dollar a year industry globally, 17% of the US population is currently on a diet. The Paleo diet has gained mainstream popularity in the past couple of years, and with it, many misunderstandings and erroneous beliefs have become dogma. What does science say about Paleo? Can an athlete eat a Paleo diet? What about someone with chronic disease? What does Paleo say about lifestyle? Ditch your loincloth and learn how to avoid common mistakes when implementing a Paleo lifestyle and become healthier, stronger and savvier while you learn how to make Paleo work for you!
Sign up for this class and learn more about Paleo:
Demistyfing The Paleo Diet: Introduction class
Symposium of Integrative Oncology Presentation
This is the poster presentation I made at the Symposium of Integrative Oncology. It deals with a botanical extract that is able to rescue p53 protein from virally infected and transformed cancerous cells. The most important take-home from the poster is that the botanical extract is able to spare healthy cells! It specifically targets the cells that are replicating out of control, and allows the cell's ability to undergo apoptosis if the cell is infected.
If you would like a higher resolution copy, please contact me. I'll be happy to share!
How do I select a practitioner? (Part 3)
My decision of moving to Arizona to become a Naturopath was made after I grew frustrated with our current health care system. I believe that prevention of disease is the best way to combat morbidity, but once disease settles in, you have to remove obstacles to health rather than suppress symptoms to achieve true cure.
The focus of this series of articles is to help my family and friends sort through the murky waters of our current health care system, and to help them find a practitioner that will provide the best preventative care, but most importantly, that will help them find real cures when they are afflicted with an acute condition like a cold, or a chronic condition like diabetes.
In my first post I discussed strategies to find a practitioner, in the follow-up, I talked about the qualities and intangibles your practitioner should have. In this third post, I will discuss the concept of removing obstacles to health.
Imagine driving your car and that pesky “check engine light” turns on. You are worried, since your car has been pretty reliable, and you’ve made the oil changes every three thousand miles, you check your coolant and have your tires aligned. You know whatever is going on under the hood is probably minor, and you take it in for a checkup. The mechanic takes in your vehicle and tells you “yes, I’ve seen this before”, and he promptly disconnects the light behind the dashboard. The symptom is gone, you no longer have a “Check Engine” light on your dashboard, but you know that there must be something wrong. The mechanic just deactivated the alarm that tells you to check your car.
Would you pay your mechanic? Most importantly, maybe the problem with your car was simple, but disabling the annoying light and not correcting the actual problem will most likely create a bigger problem.
Now imagine you have a headache. You’ve been working outside all day long and forgot your water bottle. You have two options, you could go inside and take some aspirin and get rid of the headache, or you could drink some water. Both options will remove your symptom. But only one will fix the problem. The problem that created the headache was a water deficiency. There is even a medical term for it: dehydration. I have never heard of anyone having an aspirin deficiency. Both options will get rid of the pain. Taking a medication that suppresses symptoms is like that mechanic disabling the check engine light. Now imagine all of the different symptoms that are suppressed in our conventional medical model. Fatigue, blood sugar dysregulation, pain. The list is endless. Every time a practitioner dismisses or suppresses symptoms (such as fatigue, headaches, chronic pain) they are silencing your internal alarm, and thus maybe creating a bigger problem.
Why do we settle for a system of medicine that is not correcting the actual problem? You should select a practitioner that focuses on removing the obstacles to health, and not just suppression of symptoms.
Sometimes suppression of symptoms is necessary. Have you ever broken a bone? If you have a bone fracture, your body will tell your brain there is a problem with localized pain. The course of treatment for a broken bone is simple. Pain (the symptom) is controlled with pain medication, and a doctor will set the bone fracture (the underlying cause for the symptom) using a splint, a cast or even surgery. The pain will be present until complete resolution; but the pain medication will not fix the broken bone. Pain medication is given to help the patient deal with the symptom, because no one should suffer through pain. The suppression of the symptom (in this case pain) will help the patient heal faster, but the patient will only heal if the obstacle to health (in this case the fracture) is removed. Most importantly, no practitioner would ever recommend to be on pain medication long term, in fact, we should encourage the patient to reduce pain medication as quickly as possible. In this case, the obstacle to health is so clear, that our current system of practice works perfectly.
What happens when the obstacle to health is not clear? Let's talk about a common chronic disease: diabetes. Diabetes is a common disease, either you or someone you know suffers from diabetes. Type II diabetes (DMII) affects blood glucose regulation (actual problem), and presents with very clear symptoms polydipsia, polyurea and polyphagia. What causes DMII is not so clear, and if you are reading this blog, you are probably in the camp that believes that DMII is caused by lifestyle choices and genetics and not just dumb luck. How do we treat diabetes? If someone suffers from DMII, they might need an insulin sensitizer in order to get the blood sugar back under control, but medication should never be used as a crutch to allow patients to continue eating a high sugar diet. Medications should be prescribed with the goal of amelioration of symptoms - in the short term, until homeostasis is reached. In this case, the real culprit is lifestyle, and correcting lifestyle choices is the real problem, no amount of metformin or insulin will ever replace the need for a proper diet coupled with optimized lifestyle decisions.
In our current system of healthcare, the symptoms of DMII are treated with insulin sensitizers. When the insulin sensitizer stops working and the symptoms come back, we add insulin to the problem. When that stops working, we increase the dose. How many people do you know that have cured themselves from DMII? And of those people, how many did it by losing weight vs. adding more medications?
Beware, you could also fall into a trap with holistic practitioners that might want to treat using more "natural alternatives". One example comes to mind: one of my friends told me “My doctor is very natural, before he prescribed anything to help reduce my blood sugar, he recommended a cinnamon supplement”. Substituting a natural product for a medication does not make a better practitioner. My friend did not have a cinnamon deficiency, my friend needed lifestyle modifications to fix his “check engine light”. Your practitioner should be able to identify when medications, supplements and lifestyle modifications are appropriate, and be able to recognize the patterns and obstacles to your health.
If your practitioner is prescribing a medication or a supplement for a condition that could be avoided with a lifestyle modification, the practitioner is focusing on symptoms not disease. If your practitioner tells you “you will have to be on this medication for the rest of your life” you should ask for clear clarification. This is not to say that “health” means not taking any medications or supplements. Some diseases such as genetic conditions, surgeries, viral infections, hormonal problems, cancer and many might be incurable or they might have to be constantly managed with medications. In other words, some medications have to be taken forever, because we might not have cures for certain diseases. For all the other disease processes, we should focus on correcting the problem, rather than the elimination of symptoms in order to prevent an acute illness from becoming chronic or even worse, incurable.
In summary, find a practitioner that has clear goals to health, that has ideas on how to measure true health outside of the numbers on your lab report. Look for a practitioner that is practicing with a focus on preventative medicine, well within their scope of practice. Your practitioner should keep up with research and most importantly change the approach to disease as the evidence changes. Your practitioner should focus on removing obstacles to health, not just symptom suppression. And finally, your practitioner should be your ally, not your boss. They should show compassion and they should be open minded. It might take you some time to find a good practitioner, but once you find your practitioner, you will have an indispensable ally in your journey to health.
There are many reasons this article could be helpful to you or your friends; maybe you feel that there is room for improvement in your health, maybe you have an acute condition that needs to be checked or maybe you were diagnosed with a chronic disease. In any case, you should never settle for cookie-cutter healthcare. You should empower yourself to find a practitioner that will work with you to bring true cure.
How do I select a practitioner? (Part 2)
I came to Arizona to become a Naturopath, because I want to help my patients find true health from a holistic and science based approach. I want my patients to enjoy true health, not just suppression of symptoms. Since I still have a year and a half until I can practice, I wanted to publish a guide to help my friends and family find their doctor.
It is unfortunate that I can’t just tell my friends “go find a functional medicine doc” or, just look for a Naturopath. For the most part, the way we practice medicine (as a whole) is not conducive to true health. We have to be selective when we trust our health to a practitioner. Most importantly, every profession has practitioners that lack the tools to truly help their patients. This is not to say that conventional medicine is malicious, or that holistic doctors are superior. Every practitioner that is true to their profession has the best interest for their patient, it just means that sometimes you need more than just a prescription or a specific modality to find real health.
How will you find a practitioner that is concerned with true preventative medicine? Or, maybe you developed or know someone with a chronic condition such as cancer, MS, Alzheimer’s, diabetes, etcetera, and you want to look at complementary options.
In my previous post I discussed simple steps to narrow down the pool of practitioners. In this follow up post, I will discuss why the letters behind the name are sometimes not as important as the type of practitioner selected.
When I first started learning about the Paleo diet, one of the most informative podcasts I listened was “The Paleo Solution” with Robb Wolf. It was during one of his episodes that I learned about Chris Kresser a licensed acupuncturist. Chris Kresser has influenced my philosophy of health more than any book, doctor, talk, or documentary. He practices functional medicine, or a type of medical practice or treatments that focus on optimal functioning of the body and its organs, usually involving systems of holistic or complementary medicine. In other words, a type of care that optimizes your body, even if you are not sick.
Having the appropriate philosophy of practice will be more important than the type of degree your practitioner holds. Your doctor should focus on true cure, they should address the illness and not just the symptoms, and they should be concerned on all aspects of health (emotional, physical, social) and not just concerned with the numbers printed on your lab report. There are other intangibles that your practitioner should have. For example, if your doctor holds a doctorate degree from an Ivy school, but is not willing to listen, is not up to date with the literature and is not compassionate, he might not be the best practitioner for you. On the other hand, you could go to an acupuncturist, that has experience dealing with your concerns, is willing to work with you and has the right approach to correct illness.
Beware, your practitioner must practice within the limits of their scope of practice. This is very important, you want to be treated by someone who is honest and practices well within the scope of their professional training. This might be limiting, for example, an acupuncturist might not be able to order labs or prescribe medications. Sometimes these obstacles can be circumvented. Functional medicine practitioners might have associations with other licensed practitioners that have laboratory or prescription rights. Having those associations allow for truly integrative care, and having more than one practitioner working on your case has advantages. The integrative approach allows for more scrutiny and it prevents one practitioner from over prescribing labs or over utilizing drugs or supplements.
Health can come from many different places. I believe that the best place to start the healing is the kitchen, and Mom can be the catalyst of healing the whole family. You can also find inspiration from family members, friends, bloggers or writers. I am enrolled in Naturopathic school because of the influence people like Robb Wolf and Chris Kresser have had on me. Do not get confused, only a licensed professional can prescribe you pharmaceuticals, supplements, order labs and diagnose you with a disease. But a health coach can guide you to better health. Your health coach can be a nutritionist, a personal trainer or your yoga instructor. They are not your doctor. The same goes for podcasts or blogs, they can guide you on your quest for health, but never use podcasts, blogs or videos to come up with your own diagnosis or to treat yourself.
Finally, make sure your doctor has an open mind. No matter who you chose as your practitioner, make sure that they use the latest research to treat you. Your doctor has to know the limitations of treatment, and have to be aware of not being confounded by their expertise or method of practice. For example, using an herb might be gentler than using a prescription drug, but, botanicals do not have the same level of quality control as pharmaceuticals, their dosage guidelines are very murky, and therefore they might not be as effective as a prescription drug. Acupuncture might be amazing for chronic pain, but it will probably do little for a broken bone. Same with surgery, removing your gallbladder might be one of the worst things you do to fix gallstones. Never let practitioner confirmation bias be the reason your health does not improve.
In my final post of the series, I will talk about removing obstacles to health, and how that is the basis of finding true health. Thanks for reading!